Too Few Dentists and Hygienists, Too Many Barriers to Entry for Out-of-State Practitioners

By Scotte Hudsmith, President of the Association of Dental Support Organizations 

Texas is facing a dental workforce crisis. As of April 2025, data from the U.S. Department of Health and Human Services shows that there are 264 dental health professional shortage areas (HPSAs) across the state. These are areas where there simply aren’t enough providers to meet the community’s needs. 

But there is a clear and common-sense solution that can help fill some of these gaps, and it is currently under consideration in the Texas Legislature. If passed into law, HB 1803 would sign Texas on to the Dentist and Dental Hygienist (DDH) Compact, allowing licensed dentists and dental hygienists from other compact-participating states to more easily relocate and practice in Texas. This policy addresses our dental industry’s workforce shortage while making certain more Texans can access the dental care they need. 

At the Association of Dental Support Organizations (ADSO), we represent 21 member companies in Texas that support thousands of dental professionals across the state. Increasing access to affordable, top-quality dental care is central to our association’s mission. A key part of that work is supporting licensure portability, which HB 1803 directly advances. 

Texas continues to attract new residents thanks to its business-friendly climate and high quality of life — but when it comes to dental licensure, the system isn’t keeping up. Burdensome and redundant regulations create unnecessary barriers that prevent qualified dental professionals from moving to and practicing in Texas. These bureaucratic hurdles are especially discouraging for early-career dentists, 15 percent of whom relocated to a different state between 2019 and 2022. HB 1803 would help fill these gaps in our industry by streamlining the dental licensure process and allowing highly trained providers to contribute their skills and expertise without getting stuck in red tape. 

The bill would also bring much-needed relief to dental professionals who come from military families. With 15 military installations across Texas, it’s common for service members and their families from every corner of the country to relocate to our state. When that happens, no one should have to choose between their profession and supporting their loved one in uniform. HB 1803 would make it easier for military spouses in the dental profession to continue career when their families are relocated to Texas. 

To be clear, HB 1803 does not eliminate licensing requirements for out-of-state dental care providers. It maintains strong protections for patients and, instead, establishes a streamlined process for dentists and dental hygienists who are already licensed in another compact-participating state — all of which have rigorous training and credentialing standards. In other words, HB 1803 simply makes it easier for licensed and experienced practitioners to bring their skills to Texas and help us resolve our dental workforce crisis. 

Licensure portability is already working across the country. Twelve states — including our neighbor Arkansas and nearby states Kansas and Colorado — have enacted the DDH Compact. Missouri is likely to join them soon. Texas has long embraced professional licensing compacts for other fields, including nursing, EMS, psychology, physical therapy, and medicine. It’s time to do the same for dental professionals. 

HB 1803 is championed by a broad and respected coalition of stakeholders, including the American Dental Association, the American Dental Hygienists’ Association, the American Dental Education Association, the Council of State Governments, the U.S. Department of Defense, and numerous state dental boards and educators. These are organizations that understand both the profession and the needs of patients, and they overwhelmingly support the bill. 

Texas needs more qualified providers, and HB 1803 will help us get them. That is why I urge our representatives in the Texas Legislature to take a decisive step toward building a stronger, more resilient dental workforce for the people of Texas and pass HB 1803.